Title Page, Copyright, Dedication

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pp. i-vi

Contents

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pp. vii-viii

Illustrations

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pp. ix-x

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Acknowledgments

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pp. xi-xiv

Nursing with a Message was never meant to be a book-length project. Its origins lay in a long-ago request that I present a paper on some aspect of the history of women’s health at the 2010 Congress of the International Council on Women’s Health Issues hosted by my School of Nursing in Philadelphia. I knew the Barbara Bates Center for the Study of the History of Nursing, my intellectual home for the past thirty years, held Susan Reverby’s anthology of pamphlets written by public health nurses involved in an interesting maternal-child health project in the East Harlem section of...

Abbreviations

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pp. xv-xviii

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Introduction

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pp. 1-12

On March 10, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Seven months later a key feature of the bill, the Center for Medicare and Medicaid Innovation (Innovation Center), opened its doors. While the ACA looks to restructure key features of the US healthcare payment systems, the Innovation Center serves as an incubator of new ideas to deliver and pay for care that will improve quality and decrease costs. To this end, its $10 billion budget sets in motion demonstration projects to increase access to high-quality, cost-effective,...

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Chapter 1. Medicine and a Message

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pp. 13-34

Public health reformers had every reason for optimism at the dawn of the 1920s. Two seminal events had set grand plans in motion. The first, the decision of the American Red Cross (ARC) that its newly reconfigured peace-time mission would concentrate on the more effective organization of health and social services through neighborhood health centers, promised to solve the knotty problem of care coordination among the myriad of public and private entities operating in large urban areas like New York City. The second, the release of data from the Metropolitan Life Insurance...

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Chapter 2. The Houses That Health Built

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pp. 35-56

On November 10, 1921, New York City’s East Harlem Health Center Demonstration Project (Health Center) opened to great fanfare. The Health Center self-consciously characterized itself as a “department store of health and welfare” playing on the success of a new middle-class institution that promised everything one could imagine buying in one central location. Similarly, the Health Center gathered twenty-three of the neighborhood’s health and social welfare agencies into one newly refurbished building for the same kind of “one-stop shopping” for coordinated health and welfare...

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Chapter 3. Practicing Nursing Knowledge

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pp. 57-78

By 1931, supporters of the new Nursing Service had a consistent message that it sent to the Rockefeller Foundation in support of its practice and teaching missions. Grace Anderson, in her report to the Foundation on the work of its Teaching Service, spoke directly to its significant success in “pooling of professional knowledge and skills in working out the essentials of a family health program for the community.” Only in East Harlem—and, she argued, nowhere else in the country—could observation and practice be directly correlated with theoretical instruction in education, psychology,...

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Chapter 4. Shuttering the Service

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pp. 79-100

New York City’s nurses and social workers witnessed firsthand the devastation wrought by what was at first haltingly described as a “business depression,” or an “emergency.” The Research Bureau of the city’s Welfare Council, the now new and privately funded agency also addressing the issue of coordinating the delivery of health and social welfare services, turned to them to gain an initial “impressionistic” view of the plight of families and individuals during the harsh winter of 1930 and 1931. Some nine hundred women making close to their normal four thousand visits to homes each day...

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Chapter 5. Not Enough to Be a Messenger

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pp. 101-112

In the early 1920s, those who would reform the US healthcare system established a small series of demonstration projects that would provide patients access to high-quality, cost-effective, and expertly coordinated healthcare. Much like the goals of those supported by today’s Center for Medicare and Medicaid Innovation, these demonstration projects would translate ideas into practices that could be easily adopted by existing healthcare structures. Many of the demonstration projects of the 1920s proved successful and many of the practices they supported proved enduring. They established...

Notes

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pp. 113-130

Bibliography

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pp. 131-134

Index

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pp. 135-146

About the Author

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pp. 147-152